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下午行强化与常规护理腹腔镜子宫切除术的术后恢复:一项随机对照试验。

Recovery after enhanced versus conventional care laparoscopic hysterectomy performed in the afternoon: A randomized controlled trial.

机构信息

Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Department of Anesthesiology and Intensive Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

出版信息

Int J Gynaecol Obstet. 2020 Dec;151(3):392-398. doi: 10.1002/ijgo.13382. Epub 2020 Oct 19.

Abstract

OBJECTIVE

To compare enhanced recovery after surgery (ERAS) and conventional care (CC) protocols on outcomes of laparoscopic hysterectomy (LH) performed in the afternoon.

METHODS

A single-center randomized controlled trial was conducted on 120 women undergoing LH who were randomly divided into the intervention group (IG; n=60) and control group (CG; n=60). Women in the IG were treated according to the ERAS protocol and those in the CG according to the CC protocol. The primary outcome was the length of hospitalization. Secondary outcomes were postoperative opioid use, postoperative pain and emesis, complications, operative bleeding, and time.

RESULTS

More women discharged during 24 hours in the IG than in the CG (88% vs 55%, P<0.001). The time to actual discharge (19 vs 22 hours, P<0.001) and ready-to-discharge time (15 vs 21 hours, P<0.001) were shorter and the use of oxycodone was lower (0 mg [0-0 vs 2.5 mg [0-10], P<0.001) in the IG than in the CG, respectively. Otherwise, no other significant differences between the groups were observed. The follow-up time was one month.

CONCLUSION

The ERAS protocol reduces hospital stay and decreases the use of opioids with no impairment in surgical outcome of LH. ClinicalTrials.gov: NCT03828981.

摘要

目的

比较腹腔镜子宫切除术(LH)下午手术时采用加速康复外科(ERAS)和常规护理(CC)方案对结局的影响。

方法

对 120 例行 LH 的女性进行了一项单中心随机对照试验,将其随机分为干预组(IG;n=60)和对照组(CG;n=60)。IG 组根据 ERAS 方案进行治疗,CG 组根据 CC 方案进行治疗。主要结局是住院时间。次要结局包括术后阿片类药物使用、术后疼痛和呕吐、并发症、手术出血和时间。

结果

IG 组中在 24 小时内出院的女性多于 CG 组(88% vs 55%,P<0.001)。实际出院时间(19 小时 vs 22 小时,P<0.001)和准备出院时间(15 小时 vs 21 小时,P<0.001)较短,IG 组的羟考酮使用量也较低(0 毫克 [0-0 比 2.5 毫克 [0-10],P<0.001)。

结论

ERAS 方案可缩短 LH 的住院时间,减少阿片类药物的使用,而不影响手术结果。临床试验注册:NCT03828981。

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